Doctors urge Congress to overhaul Medicare payment formula

Matt Paul and Radio Pennsylvania
| 10.29.13

(Hershey) -- Doctors are urging Congress to overhaul the formula for calculating Medicare payments. Without action, a 25 percent cut to Medicare reimbursements is looming on January first.

Congress has enacted 15 patches over recent years to avoid similar cuts to Medicare payments. Now the American Medical Association says it's time to repeal and replace what it calls a broken formula.

AMA President Ardis Hoven, who was in Hershey last week to address the Pennsylvania Medical Society, says Medicare's sustainable growth rate is neither sustainable, nor allows for growth.

"It is a formula that the federal government uses to calculate physician payment in providing care to Medicare patients," she says. "This formula is based on the [gross domestic product] it is not based on the cost of providing care to these patients."

Dr. Hoven says the current formula is holding the medical profession back from implementing new patient care models that can lead to better prevention and maintenance of chronic conditions.